Intertrochanteric fracture of femur
Introduction
Introduction to intertrochanteric fractures Femoral intertrochanteric fracture refers to the fracture of the femoral neck from the basal to the trochanter level. It is also a common injury to the elderly. Because the blood circulation of the rotor is rich, and there is very little non-union after fracture, the prognosis is much better than that of the femoral neck fracture. In the patients with intertrochanteric fracture, the mortality rate of the traction treatment group is 34.6%, while the mortality rate of the internal fixation group is 17.5%. . Due to the improvement of surgical techniques and the continuous development of internal fixation materials, the occurrence of surgical complications has been greatly reduced. Surgical treatment of intertrochanteric fractures has become the preferred method. basic knowledge Sickness ratio: 0.05% Susceptible people: good for the elderly Mode of infection: non-infectious Complications: Acne
Cause
Causes of intertrochanteric fractures
Direct violence (30%):
Violence directly affects a part of the bone and causes fractures in the part, which often causes fractures in the injured area, often accompanied by varying degrees of soft tissue destruction. If the wheel hits the calf, a fracture of the humerus shaft occurs at the impact.
Indirect violence (35%):
Indirect violence causes fractures in the distance through longitudinal conduction, leverage or torsion. When the foot falls from a height, the trunk flexes forward rapidly due to gravity, and the vertebral body at the junction of the thoracolumbar spine is subjected to folding force. The role of compression fracture (conduction).
Accumulated strain (25%):
Long-term, repeated, mild direct or indirect injury can cause a specific part of the limb to fracture, such as long-distance marching to cause the second, third metatarsal and the lower third of the humerus fracture.
Prevention
Femoral intertrochanteric fracture prevention
For patients who have been injured for 1 to 2 weeks, the diet needs to be light, easy to absorb and digest. They should be given more vegetables, fruits, fish soup, eggs, soy products, etc., and should be mainly steamed or stewed. Eat spicy, greasy and fried foods. In particular, you can eat more honey and bananas, because most patients in bed will have symptoms such as constipation, these foods can help defecation.
Complication
Complications of intertrochanteric fractures Complications
(1) Shock: severe injury, caused by major bleeding or major organ damage.
(2) Fat embolism syndrome: occurs in adults, due to excessive tension in the hemorrhage of the sacral cavity in the fracture, fat drops into the ruptured sinus, can cause lung and brain fat embolism.
(3) Important internal organ damage:
1. The liver and spleen rupture.
2, chest and lung injury.
3, bladder and urethral injury. Intestinal damage.
Symptom
Femoral intertrochanteric fracture symptoms Common symptoms Severe pain comminuted fracture Hip varus lower limb shortening
The intertrochanteric is a prone site for osteoporosis. The rate of osteoporosis is faster in the trabecular bone and slower in the femoral moment. The joint between the lower bone beam and the slower developing femoral moment is The weakest part of the bone is therefore prone to intertrochanteric fractures. After the injury, there was pain in the quasi-sub-zone, swelling, ecchymosis, and inability to move the lower limbs. The examination found that the intertrochanteric tenderness was obvious, and the external extremity deformity was obvious, up to 90 degrees, and there was axial pain. The measurement revealed short limb shortening. X-ray film can identify the type and displacement of the fracture.
Examine
Examination of intertrochanteric fractures
X-ray films should include positive and lateral positions, and the wells must include adjacent joints, and sometimes x-rays of oblique, tangent or corresponding parts of the contralateral side must be added. After reading the x-rays carefully, you should identify the following points:
(1) The fracture is invasive or pathological.
(2) Whether the fracture is displaced and how to shift.
(3) Whether the fracture alignment is satisfactory to the line and whether it needs to be rectified.
(4) Whether the fracture is fresh or old.
(5) Whether there is damage to the joint or bone injury.
Diagnosis
Diagnosis and diagnosis of intertrochanteric fractures
According to its clinical manifestations and X-ray examination, the disease can be clearly diagnosed without identification. However, it is necessary to pay attention to the clinical occurrence of fractures, whether it is a simple fracture or a pathological fracture caused by the patient's own disease. In the case of abnormal bone disease caused by the patient's original disease, a slight force can cause a fracture. In this case, it occurs more frequently and needs to be strictly observed and diagnosed.
